The 2001 NHS found almost 78% of the Australian population reported one or more long-term conditions (i.e. conditions that have lasted, or are expected to last for six months or more). In most cases, respondents were asked about conditions which had been medically diagnosed.

Among adults aged 18 years and over in 2001, females in general were more likely than males to report selected long-term conditions with the exception of total/partial hearing loss (table 9.2). While similar proportions of females and males reported having back problems, diabetes and neoplasms, females were more likely to consult health professionals. For example, in 2001 it was estimated 27% of females had consulted a doctor in the two weeks prior to the survey interview, compared with 21% of males. Females also have a longer life expectancy. This results in higher proportions of females in the older age groups where long-term conditions are common. Adult males had a higher prevalence of neoplasms and hearing loss.

The proportion of people who reported back pain, back problems and disc disorders increased rapidly after early teenage years from 2% among those aged 10-14 years, to 30% among people aged 40-44 years. Prevalence then decreased among those aged between 65 and 85 years before increasing slightly among people in very old age (graph 9.3).

The proportion of people reporting diabetes mellitus as a long-term condition remained below 1% among people aged less than 35 years before slowly increasing. Rates then remained between 10% and 12% for those aged in their early-60s to late-70s before the proportion declined.

The proportion of people who reported having malignant neoplasms also remained relatively low at under 1% among people aged less than 35 years. After this age, proportions of people reporting having a malignant neoplasm steadily increased to 6% among those aged 70 years and over.

MORTALITY

There were 132,292 deaths registered in 2003, consisting of 68,330 male and 63,962 female deaths (table 9.4). The number of deaths registered in 2003 represented a decrease of 1.1% on the corresponding figure for 2002 (133,707 deaths). The age-standardised death rate of 642 per 100,000 population in 2003 was lower than the corresponding rate of 667 in 2002. Malignant neoplasms (cancer) and ischaemic heart diseases were the leading underlying causes of death, accounting for 28% and 19% respectively of total deaths registered (table 9.4).

The age-standardised death rate of 642 deaths per 100,000 population in 2003 was 20% lower than the corresponding rate of 800 in 1993. This is consistent with continuing improvements in life expectancy in Australia.

Over the ten years to 2003 there were quite different patterns of decline in the two leading causes of death from malignant neoplasms and ischaemic heart diseases, which together account for nearly half the total deaths. Between 1993 and 2003 the standardised death rate for malignant neoplasms decreased by 12%, while the rate for ischaemic heart diseases decreased by 38% (graph 9.5).

INTERNATIONAL COMPARISONS

Healthy life expectancy

The WHO has proposed health-adjusted life expectancy as a measure of the expected number of years to be lived without reduced functioning. Healthy life expectancy calculations adjust the overall life expectancy (see Life expectancy in the Population chapter) by the years of life lived with reduced functioning because of ill health.

Australia's healthy life expectancy is among the highest in the world. Australian males can expect to live 70.9 years of life without reduced functioning, and females 74.3 years. Table 9.6 shows healthy life expectancy for selected countries in 2002.

9.6 HEALTH-ADJUSTED LIFE EXPECTANCY(a), Selected countries - 2002

Health-adjusted life expectancy

years

MALES

Japan

72.3

Iceland

72.1

Sweden

71.9

Switzerland

71.1

Australia

70.9

Italy

70.7

Norway

70.4

Canada

70.1

Spain

69.9

Germany

69.6

New Zealand

69.5

France

69.3

Austria

69.3

United Kingdom

69.1

Greece

69.1

Belgium

68.9

Singapore

68.8

Finland

68.7

Denmark

68.6

Ireland

68.1

United States of America

67.2

Portugal

66.7

Poland

63.1

Russian Federation

52.8

South Africa

43.3

FEMALES

Japan

77.7

Spain

75.3

Switzerland

75.3

Sweden

74.8

France

74.7

Italy

74.7

Australia

74.3

Canada

74.0

Germany

74.0

Iceland

73.6

Norway

73.6

Austria

73.5

Finland

73.5

Belgium

73.3

Greece

72.9

New Zealand

72.2

United Kingdom

72.1

Portugal

71.7

Ireland

71.5

Singapore

71.3

United States of America

71.3

Denmark

71.1

Poland

68.5

Russian Federation

64.1

South Africa

45.3

(a) Health-adjusted life expectancy is based on life expectancy, but includes an adjustment for time spent in poor health.

Source: WHO 2004.

Infant mortality rates

The infant mortality rate (IMR) is defined as the number of deaths of children under one year of age per 1,000 live births. In 2003, 1,200 infant deaths were registered in Australia. This number was 25% lower than the number registered in 1993 (1,600), and 48% lower than in 1983 (2,300). The infant mortality rate of 4.8 infant deaths per 1,000 live births in 2003 was 22% lower than the IMR in 1993 (6.1 deaths per 1,000 live births), and half that recorded in 1983 (9.6 deaths per 1,000 live births). Australia's infant mortality has declined significantly in the last 100 years. In 1903, over one in ten infants born did not survive to their first birthday (IMR of 111). In 2003, around one in 200 infants born did not survive their first year of life (IMR of 4.8) (graph 9.7).

The early decline in infant mortality has been linked to improvements in public sanitation and health education. Later declines may be a consequence of the introduction of universal health insurance (Medicare) and improvements in medical technology, such as neonatal intensive care units.